Coronary artery bypass graft surgery consists of bringing blood from a source of normal arterial pressure through grafts that are attached to the coronary arteries where they have been surgically opened beyond the obstructed area. If the coronary arteries are too small or too severely diseased for such surgery, they are also too small for balloon dilation and stent insertion. Therefore, these patients are left with incomplete revascularizations. This can lead to subsequent need for re-operation for angina pain, heart attacks, rhythm disturbances or death.
Coronary arteriograms show only the larger arteries, and cannot show vascular disease in small arteries. Therefore, incomplete revascularization cannot be recognized when it is due to small arterial branch obstructions often frequently present in diabetics, but also elderly people, and patients after a heart attack.
In areas of inadequate perfusion as above, mechanical methods were attempted to make ventriculo-myocardial channels using primarily cannulas or trocars. They failed apparently because they produced slits instead of channels.
A system using lasers to create ventriculo-myocardial channels was used more successfully and transiently the recognized alternative surgical approach when coronary bypass grafting and balloon angioplasty was not possible. Unfortunately the laser channels frequently closed as well. The closure of these channels is postulated to be due to the high temperature generated by the laser which causes burned channel walls with subsequent scarring and closure.
Other revascularization techniques have been proposed. One involves boring holes in the heart muscle. The boring is designed to generate heat and cauterize the wound. The heart will then generate new arteries and veins around the channel wall. The heart, it is postulated, will then generate new arteries and veins around the cauterized channels, a process referred to as angioneogenesis. This procedure does not provide immediate supplemental blood flow to the heart or other organ during surgery, making it impossible to predict success.
Thus there exists a need for a procedure that provides immediate supplemental blood flow to the heart or other organ when bypass grafts or balloon angioplasty cannot be performed.